Patient Benefit Rep Sr

Overview

The US Oncology Network is looking for a Patient Benefits Representative to join our team at Texas Oncology
. This full-time position will support the Revenue Cycle Department at our 1609 Hospital Parkway clinic in Bedford, Texas. Typical work week is Monday through Friday, 8:30a - 5:00p.

Note from Hiring Manager: This is a great team, and Texas Oncology is a great company to work for!

This position will be a level 1 or Sr depending on relevant candidate experience.

As a part of The US Oncology Network
, Texas Oncology delivers high-quality, evidence-based care to patients close to home.
Texas Oncology is the largest community oncology provider in the country with approximately 530 providers in 280+ sites across Texas. Our mission is to use leading-edge technology and research to deliver high-quality, evidence-based cancer care to help our patients achieve "More breakthroughs. More victories."

The Patient Benefits Representative, under general supervision, is responsible for educating patients on insurance coverage and benefits. Assess patients’ financial ability; may educate patients on assistance programs. Updates and maintains existing patient insurance eligibility, coverage, and benefits in the system. Supports and adheres to the US Oncology Compliance Program, including the Code of Ethics and Business Standards, and US Oncology’s Shared Values.

• Prior to a patient receiving treatment; obtains insurance coverage information and demographics; educates patient on insurance coverage, benefits, co-pays, deductibles, and out-of-pocket expenses.
• Assess patients’ ability to meet expenses and discusses payment arrangements. May educate patients on financial assistance programs as well as identify sources and provide assistance with completing forms. Based upon diagnosis, estimated insurance coverage, and financial assistance, completes Patient Cost Estimate form.
• Completes appropriate reimbursement and liability forms for patient’s review and signature. Forwards appropriate information and forms to billing office.
• Responsible for obtaining, from Clinical Reviewer, insurance pre-authorization or referral approval codes prior to each treatment.
• Review patient account balance and notify front desk of patients to meet with.
• Ensure that patient co-pay amount is correctly entered into system (or conveyed), allowing front desk to collect appropriately.
• At each patient visit, verifies and updates demographics and insurance coverage in computer system according to Standard Operating Procedures (SOPs).
• Stays current on available financial aid. Develops professional relationships with financial aid providers. Networks with financial aid providers to obtain leads to other aid programs.
• Adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regards to patient records.
• Maintains updated manuals, logs, forms, and documentation. Performs additional duties as requested.
• Other duties as requested or assigned.

The ideal candidate for the Patient Benefits Representative will have the following background and experience:

Level 1

• High school diploma or equivalent required.
• Minimum three (3) years patient pre-services coordinator or equivalent required.
• Proficiency with computer systems and Microsoft Office (Word and Excel) required.
• Demonstrate knowledge of CPT coding and HCPCS coding application.
• Must be able to verbally communicate clearly and utilize the appropriate and correct terminology.
• Must successfully complete required e-learning courses within 90 days of occupying position.

Level Sr (in addition to level 1 requirements)

• Associates degree in Finance, Business or four years revenue cycle experience preferred.
• Minimum three (3) years pre-services coordinator experience and two (2) years of patient benefits experience required.
• Must be able to demonstrate knowledge and appropriate application of insurance coverage benefits and terminology.

Competencies:

• Uses Technical and Functional
  
  Experience:
  
  Possesses up-to-date knowledge of the profession and industry; is regarded as a subject matter expert in…